M46.86

Billable

Other specified inflammatory spondylopathies, lumbar region

HCC Category Mapping

V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.307

ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.000

What This Code Means

Inflammation of the spine in the lower back (lumbar region) that doesn't fit into other specific categories.

Coding Tips

•Use when inflammatory spondylopathy is documented in the lumbar region without meeting criteria for more specific diagnoses
•Common site for inflammatory spine conditions; ensure documentation supports inflammatory rather than degenerative etiology

Clinical Significance

Non-infectious lumbar inflammatory spondylopathies significantly impact mobility and function due to the mechanical demands on the lumbar spine. These chronic conditions require long-term anti-inflammatory management and monitoring for both inflammatory activity and functional outcomes.

Documentation Requirements

✓Lumbar spine involvement (L1-L5)
✓Non-infectious inflammatory etiology confirmed
✓Lumbar MRI showing inflammatory changes
✓Functional disability assessment
✓Inflammatory marker monitoring
✓Response to anti-inflammatory therapy
✓Lumbar mobility and strength evaluation
✓Quality of life measures

Commonly Confused Codes

M46.56 — Infective lumbar spondylopathy when infectious M46.87 — Lumbosacral region when involving L5-S1 M47.816 — Lumbar spondylosis with myelopathy when degenerative M54.5 — Low back pain when pain is primary without inflammation

Code Hierarchy

└M46Other inflammatory spondylopathies └M46.8Other specified inflammatory spondylopathies └M46.86Other specified inflammatory spondylopathies, lumbar region

└M46.86Other specified inflammatory spondylopathies, lumbar region